Dr. Warren and Dr. Biss relate their success in attempting the cure of the colica pictonum, as it is denominated by one, and the dry belly ach by the other, by means of a salivation with mercury; and observe, that as soon as the ptyalism was perceived, the pain abated, and returned no more. One of these gentlemen observes, that in mild cases, where a salivation seemed not necessary, blisters applied to the upper and fore part of the thighs, near the groin, were sometimes effectual. Dr. Hugh Smith advises to apply the blisters on the belly.
Dr. Grashuis commends alum as a specific in this disorder: and Dr. Percival, in his Ess. Med. and Exp. relates the success which hath attended his use of this medicine in various painful disorders of the bowels. He gives it from gr. x. ad xx. every four or six hours; and a few doses, thus administered, never failed to procure relief, and, duly repeated, to effect a cure.
"In violent colics," remarks Dr. Percival, (Med.Commentaries, vol. v. p. 172.) "attended with vomiting and an obstinate constipation of the bowels, it has been the common practice amongst physicians to give opiates, in conjunction with purgatives. This method of treatment has been lately improved by administering the opiate first, and the purgative an hour or two afterwards. But I take the liberty of suggesting to you another mode, which, as far as my own experience extends, has proved the most successful. I directed three or four ounces of a strong decoction of poppy heads, with twenty, thirty, or forty drops of tinctura opii, to be injected into the intestines, and retained as long as possible. If it be speedily discharged, the clyster is repeated till the pain is relieved, and the vomiting ceases. A dose of calomel and jalap, or any other brisk cathartic, is then administered; and its operation quickened by the use of sena tea, of a solution of the neutral salts, or of castor oil. By this process, evacuations are procured with more ease, certainty, and expedition, than by any other which I have tried. For opium, when given in a clyster, does not check the peristaltic motion of the intestines, nor counteract the operation of any purgative so powerfully as when received into the stomach. And, in this way, it is most efficacious in alleviating the sickness, and in putting a slop to the violent retchings, with which colics are often attended. The taste of laudanum is often so nauseous, that it is frequently rejected as soon as swallowed. And, if the extractum opii be given in a solid form, time must be allowed for its solution, before any effect can be expected from it."
On this subject we need scarcely repeat the remark, which we have had occasion to make, viz. that the opiate should be first given, and left to produce its full effects, before the purgative is administered; nor have we found the remark of Dr. Percival confirmed by practice, that opium in clysters is less constipating than by the mouth.
The palsy which remains after the removal of the colic is best relieved by the use of Bath water; but as the circumstances sometimes do not admit of this method, the whole length of the spine may be rubbed with Barbadoes tar, dissolved in rum; and such other anti-paralytics may be used as the constitution of the patient, and other circumstances, may admit.
The third species, the colica stercoraria, arises in almost every instance, from a want of irritability in the bowels. In old people, it amounts to a paralytic torpor; and, though it may arise from calculi, yet this cause is exceedingly rare, and it is more often owing to palsy. It is then attended with no pain; and the disease scarcely admits of even temporary relief. The most active purgatives have no effect; and we gain little benefit from the warmest liniments rubbed on the spine, or into the abdomen. In younger persons it is removed by powerful cathartics: the oily ones have been preferred; but we have found the resin of jalap, combined with soap, the most successful.
The fourth and fifth species, c. accidentalis and me-conialis require little comment. Manna, sweet oil, or a common clyster, easily relieve the latter: and any common purgative the former.
The colica callosa is the disease styled the scirrho contracted rectum. The contraction is, however, beyond the reach of a topical remedy; and the disease is distinguished by the alternation of obstinate constipation, with a thin watery ineffectual discharge. It is a very rare occurrence; and the patient is usually left with little exertion in his favour. In a long practice, we have not seen more than four cases. Should another occur, we shall be tempted to employ a remedy some time since fashionable, mercury, divided by the extract of cicuta. If it is ever useful, which we doubt, the scirrho contracted rectum may be relieved by it. The c. calculosa scarcely ever occurs in the human body.
Colica flatulenta. The flatulent colic is usually a symptom or consequence of some other disorder, and is neither accompanied with fever nor thirst; however, the pain is acute, as the seat of the complaint is in the small intestines. Cardialgic symptoms, with efforts to vomit, sometimes attend; and a costiveness is the consequence of the great distention.
It is frequently caused by wetting the feet, or otherwise checking the perspiration. Rubbing the legs with warm cloths, and afterwards keeping the feet for some time in warm water, will be the most effectual remedy.
When a person is subject to frequent returns of this disorder, it proves that the digestive powers are weak; and warm tonics are the most effectual remedies. The columbo root and quassia are, however, preferable to bark and cascarilla.
To promote the discharge of wind, clysters of warm water, with a large proportion of carui seeds, may be frequently repeated. Warm gums, as in the gum pill, are useful; and a solution of the asafoetida may be injected as a clyster. Warm camomile tea may be now and then drunk; and tincture of rhubarb, with a few drops of the oil of mint, will be occasionally necessary. Sometimes the conf. opiata, joined with rhubarb, gives speedy relief.
See Trochin on the Colica Pictonum, with Schom-berg's Notes. Thierry on the Colica Pictonum. De Haen on the Colica Pictonum. Huxham on the Colic of Devonshire. Warren's Account of the Colica Pictonum, in the Lond. Med. Trans. vol. i. ii. Sydenham's Works, with Notes, by Wallis. Percival's Essays, Medical and Experimental, vol. ii. p. 194, etc. Medical Musaeum, vol. iii. p. 579, etc. Cullen's First Lines, vol. iv.
Colica vena is a branch from the meseraica vena major, running from the anterior part of the trunk before it joins the artery, to the middle of the colon, where it divides to the right and left, and forms arches. On the left it communicates with the upper branch of the haemorrhoidalis, and on the right with the second branch of the meseraica.
Colica recta, vena. It is a branch of the gas-trocolica vena; it goes to the right portion of the colon, from thence to its upper part, where it divides, and anastomoses with the colica and the coecalis.